Individual
NATHANEAL A MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-7350
(678) 948-7476
Mailing address
159 BURKE ST STE 201, STOCKBRIDGE, GA 30281-3410
(678) 948-7476
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW008273
GA
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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